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General NPI Number Information
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NPI Number | 1548341670
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Entity Type | Individual
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Provider Name | JOHN TANASSE D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 344 CLEVELAND AVE SE SUITE D
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City | TUMWATER
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State | WA
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Zip | 98501-3342
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Country | US
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Telephone | 360-357-5170
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Fax | 360-357-5173
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Provider Business Mailing Address
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Address Line | 344 CLEVELAND AVE SE SUITE D
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City | TUMWATER
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State | WA
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Zip | 98501-3342
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Country | US
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Telephone | 360-357-5170
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Fax | 360-357-5173
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH00033999
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License Number State | WA
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